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Software-related challenges in Swedish healthcare through the lens of incident reports: A desktop study
Get PDFYesTo identify a subset of software issues occurring in daily Swedish healthcare practice and devise a set of local solutions to overcome the challenges.
Methods: A sample of 46 incident reports was collected from one of Sweden's national incident reporting repositories, ranging from June 2019 to December 2021. The reports were first subjected to an algorithm to identify if they were health information technology-related incidents and were analysed using an existing framework, i.e., the Health Information Technology Classification System, to identify the software-related incidents. The incidents associated with software issues were then subjected to thematic analysis, in which themes were extracted and presented under the category assigned by the existing framework used.
Results: Of 46 reports, 45 (with one exception) were included using the algorithm. Of 45 incidents, 31 software-related incidents were identified using the classification system. Six types of software issues were identified, including software functionality (n = 10), interface with other software systems or components (n = 10), system configuration (n = 7), interface with devices (n = 2), record migration (n = 1) and increased volume of transactions (n = 1). Each issue was further categorised into different themes; for example, software interface-related problems were grouped into ‘two patients being active in the system simultaneously’ (n = 6) and ‘transfer of patient information’ (n = 4).
Conclusions: The study provided some insights into software issues and relevant consequences. A set of local solutions were devised to overcome the present challenges encountered in Swedish healthcare in their daily clinical practice. Systematic identification and characterisation of such software challenges should be a routine part of clinical practice for all major health information technology implementations.This work has been part of being an Affiliated Researcher at the Department of Medicine and Optometry, Linnaeus University, Sweden. A publishing grant was received from Linnaeus University as a part of the University Library's research support
Understanding the FTX exchange collapse: A dynamic connectedness approach
No full textNoEmploying a TVP-VAR dynamic connectedness analysis, we identify avenues through which the collapse of the FTX exchange manifested contagion effects throughout a number of financial markets. Results indicate that interaction effects become significantly pronounced, coinciding with key milestones during the collapse of FTX and related companies. Specifically, sources of contagion stem from two tokens created by the exchange and related companies, namely FTT Token and Serum. Such results further develop the expanding literature based on the inherent contagion effects of such unregulated products.Conlon acknowledges the support of Science Foundation Ireland under Grant Number 16/SPP/33 and 13/RC/2106 and 17/SP/5447
Optimisation of care transitions: Understanding coping strategies of South Asian family carers of a relative with advanced dementia
Get PDFBackground
With an expected increase of seven to eight-fold in the UK in the number of people from a Black Asian Minority Ethnic (BAME) heritage living with dementia, there will be a similar increase in the number of family carers. Whilst policy and research have discussed issues pertaining to awareness and access issues for minoritised ethnic communities, there remains an under-representation of these communities in services. A lack of understanding on the part of service providers as to how services could meet the needs of these carers, together with a mistrust of services, leads to bias and misconceptions about dementia care amongst South Asian families. Added to this, migrant communities are now well established in the UK, yet little is understood about the factors impacting on care and coping in the face of discrimination and prejudice. This adds to the complexities of caring for older relatives living with dementia.
Aims
The aim of this doctorate was to develop an understanding of how South Asian families cope with caring transitions connected with the care needs of advancing dementia. Emotional and physical coping strategies require some elements of individual capability but also some external elements, such as information, support and access to services.
This research set out to identify what, and how, it influenced South Asian family carers’ ability to cope, especially in the light of a lack of culturally appropriate services. I set out to explore these influences, as they are especially salient in the cultural context. The research explored how South Asian carers coped with transitions in dementia care whilst taking into consideration factors such family dynamics, cultural perspectives, values (including faith) and service provision.
Design and methods
I undertook two studies, both using a phenomenological methodology, underpinned by a social constructivist approach. The first study gathered retrospective accounts from former carers to identify key transitions in their experience of providing dementia care, and to identify factors to explore in a subsequent longitudinal study. It included in-depth semi-structured interviews with former carers from 5 families. The interviews were transcribed and then analysed using thematic analysis to identify key themes. These themes influenced the second study, where I interviewed carers from 7 South Asian families, who were actively caring for a relative living with advanced dementia. Four interviews took place bi-monthly with each family over a period of six months.
Results
Analysis identified a number of themes, which influence South Asian family carers’ ability to cope with the care needs of a relative living with advanced dementia. Study one identified five key themes, which were: stigma from family and community, access to information, appropriateness of services, expectations regarding caregiving, and attitudes arising from faith and religion regarding care provision. Family carers identified the transitioning aspects of South Asian communities themselves and how these influenced the adapting nature of culture, values and social norms in society. These include the changing nature and constructs associated with care and caregiving as care needs increase or become complicated, in relation to what is acceptable as care needs increase or become complicated. Study two incorporated findings of study one. Themes from the analysis identified some general factors, such as changing attitudes to cultural influences, faith-based impacts, carers’ own ability to cope with caring, coping as a family, gender-based influences, services and stigma as factors that impacted their coping experiences.
Conclusion
This PhD raised some interesting aspects relating to coping with care that included the value of nuanced approaches to understanding the needs of the family carers and their frustrations with barriers to accessing services that were associated with faith, gender and cultural expectations or obligations. There was a clear difference between the views of older South Asian family carers, who held more traditional values to providing care, and younger British-born carers, who saw their faith and values as not opposing their ability and desire to seek external sources of support, community or statutory services. The research therefore moves forward the previous discourse mainly restricted to awareness and attitudes. It moves it towards practical recommendations that can help support services to be more open-minded and tackle their own biases. Encouraging this, whilst taking into consideration aspects such as family-centred approaches or faith-based influences in supporting carers to better cope with the demands of caring for a relative with advancing dementia.Alzheimer’s Societ
Cancer-specific glycosylation of CD13 impacts its detection and activity in preclinical cancer tissues
Get PDFYesHarnessing the differences between cancer and non-cancer tissues presents new opportunities for selective targeting by anti-cancer drugs. CD13, a heavily glycosylated protein, is one example with significant unmetclinical potential in cancer drug discovery. Despite its high expression and activity in cancers, CD13 is also expressed in many normal tissues. Here, we report differential tissue glycosylation of CD13 across tissues and demonstrate for the first time that the nature and pattern of glycosylation of CD13 in preclinical cancer tissues are distinct compared to normal tissues. We identify cancer-specific O-glycosylation of CD13, which selectively blocks its detection in cancer models but not in normal tissues. In addition, the metabolism activity of cancer-expressed CD13 was observed to be critically dependent on its unique glycosylation. Thus, our data demonstrate the existence of discrete cancer-specific CD13 glycoforms and propose cancer-specific CD13 glycoforms as a clinically useful target for effective cancer-targeted therapy
Biodegradable Polymer Composites of Metal Organic Framework-5 (MOF-5) for the Efficient and Sustained Delivery of Cephalexin and Metronidazole
Get PDFYesThe sustained and controlled delivery of antimicrobial drugs has been largely studied using nanomaterials, like metal organic frameworks (MOFs), and various polymers. However, not much attention has been given to combining MOFs and biodegradable polymers towards the potentially more sustained release of active pharmaceutical ingredients. Herein, we report a comparative study of two widely used antimicrobial drugs, cephalexin and metronidazole, from zinc-based MOF-5 incorporated into biodegradable polycaprolactone (PCL) and poly-lactic glycolic acid (PLGA) composites. Cephalexin and metronidazole were separately loaded into MOF-5 post-synthetically, followed by their integration into biodegradable PLGA and PCL composites. The pristine MOF-5 and the loaded MOFs were thoroughly characterised using Fourier-transformed infrared (FT-IR) spectroscopy, scanning electron microscopy (SEM), thermogravimetric analysis (TGA) and powder X-ray diffraction (PXRD). Ultraviolet-visible (UV-Vis) spectroscopy studies were carried out to assess the release of the drugs in PBS for up to 72 h, showing a cumulative release of 24.95 wt% and 27.84 wt% for cephalexin and metronidazole, respectively. The antibacterial properties of the pristine MOF, pure drugs, drug-loaded MOFs and the loaded composites were assessed against Gram-positive and Gram-negative bacterial strains, Staphylococcus aureus or Staphylococcus epidermidis and Escherichia coli or Acinetobacter baumanii, respectively. A cephalexin-loaded MOF-5 composite of PCL (PCL-ceph@MOF-5) showed the best efficiency for the controlled release of drugs to inhibit the growth of the bacteria compared to the other composites. This study demonstrates that the combination of MOFs with biodegradable polymers can provide an efficient platform for the sustained release of antimicrobial drugs and can be a promising tool to manage antimicrobial resistance (AMR)
The African Continental Free Trade Area (AfCFTA): Taking stock and looking ahead for international business research
Get PDFYesThe establishment of the African Continental Free Trade Area (AfCFTA) has opened new avenues of research interest in International Business and International Management. However, scholarly work in this fledgling area of research has been disparate and often lacking in the assessment of core international business implications of the emergence of the AfCFTA on member states as well as non-member states. This is because, as yet, no systematic attempt has been made to explore the AfCFTA in the context of IB research, or project future IB research directions. Hence, in this paper, using the PRISMA method we have systematically identified the current published research and scholarly work on the AfCFTA and provided a robust picture of the current state of knowledge and available literature on the AfCFTA while at the same time outlining potential areas for future international business researc
Detection of chromosomal aneuploidy in ancient genomes
Get PDFYesAncient DNA is a valuable tool for investigating genetic and evolutionary history that can also provide detailed profiles of the lives of ancient individuals. In this study, we develop a generalised computational approach to detect aneuploidies (atypical autosomal and sex chromosome karyotypes) in the ancient genetic record and distinguish such karyotypes from contamination. We confirm that aneuploidies can be detected even in low-coverage genomes ( ~ 0.0001-fold), common in ancient DNA. We apply this method to ancient skeletal remains from Britain to document the first instance of mosaic Turner syndrome (45,X0/46,XX) in the ancient genetic record in an Iron Age individual sequenced to average 9-fold coverage, the earliest known incidence of an individual with a 47,XYY karyotype from the Early Medieval period, as well as individuals with Klinefelter (47,XXY) and Down syndrome (47,XY, + 21). Overall, our approach provides an accessible and automated framework allowing for the detection of individuals with aneuploidies, which extends previous binary approaches. This tool can facilitate the interpretation of burial context and living conditions, as well as elucidate past perceptions of biological sex and people with diverse biological traits.Open Access funding provided by The Francis Crick Institute
Leveraging the Implementation of the African Continental Free Trade Area to Address Trade Facilitation Challenges in Southern African Borders
Get PDFThis study undertakes a qualitative analysis to provide a comprehensive review of the African Continental Free Trade Area (AfCFTA) trade facilitation measures and the associated challenges of implementing them. It demonstrates how the SADC region can leverage the implementation of the AfCFTA to increase intraregional trade. Incorporating evidence from border crossing reviews, and key informant interviews of trade facilitation experts and practitioners in the SADC region, the study undertakes a detailed inductive thematic analysis of the SADC cross-border environment to investigate the potential opportunities to increase efficiency at SADC commercial borders and benefit from the AfCFTA trade facilitation measures. The analysis presents trade facilitation in the legal framework of the AfCFTA, introducing trade facilitation as a regional trade policy
tool to increase intra-SADC trade. The study finds that the AfCFTA trade facilitation measures broaden the scope of preferences and bridges the gap between the segregated and segmented markets in the SADC region, thus giving SADC Member States increased market access to other African markets outside its traditional trading routes. However, the results also show that this is insufficient to eliminate the plethora of trade barriers in the region and further strengthen intra-SADC trade without complementary measures. It contributes to the literature as it proposes and validates a conceptive policy framework for effective implementation of the AfCFTA trade facilitation measures in the SADC region
Are There Invisible Hands in Controlling Product Quality and Protecting the Environment?
Get PDFThis thesis explores whether there are invisible hands controlling product quality and protecting the environment. The first empirical chapter assesses the impact of a product recall on firm value. Using the rational expectation theory, the study
explores the market reaction to product recall announcements. The univariate analysis shows a significant negative mean return during the announcement window. The regression analysis shows that mandated recalls lead to a greater negative market reaction. The more severe the product defect, the greater the negative returns. Overall firm value is reduced following a product recall. The second empirical chapter explores the impact of debt on product recall. The thesis argues that debt has a disciplining effect on managers based on monitoring power, restrictive covenants, and rollover risk. The findings show that long-term debt is associated with increased product recall, while short-term debt is associated with reduced product recall. The study further exploits a quasi-natural experiment which controlled for observed and unobserved firm heterogeneity
through propensity score matching (PSM). The difference-in-difference (DiD) evidence suggests a causal relationship between long-term debt and product recall. The third empirical chapter explores whether there is an invisible hand protecting the environment. It assesses the impact of debt on incidences of environmental violations. The monitoring power of long-term and short-term debt forms the theoretical underpinning. The findings show that long-term debt is associated with increased environmental violations, while short-term debt is associated with reduced violations. The evidence suggests that the ex-post
monitoring of short-term debtholders can exert discipline on managers
Enhancing design and performance analysis of satellite EB/CV-QKD/FSO systems
No full textYesSatellite QKD/FSO systems, which facilitate quantum key distribution (QKD) over free-space optical (FSO) links between satellites and ground stations, present a promising pathway toward achieving global security in upcoming sixth-generation (6G) wireless communications. Our study focuses on a superior type of these systems, the satellite EB/CV-QKD/FSO, which utilizes the continuous-variable (CV) method for quantum state representation and the entanglement-based (EB) scheme for QKD implementation. We propose the use of optical phase-shift keying (QPSK) signaling and dual-threshold/heterodyne detection (DT/HD) receivers to bolster the reliability and feasibility of satellite EB/CV-QKD/FSO systems. Closed-form expressions for key system performance metrics are derived using improved channel modeling. Numerical results are presented to showcase the effects of channel impairments on the system performance. We also provide recommendations for optimal system setup parameters, aiming to enhance performance.Ministry of Information and Communications (Vietnam) (Grant Number: DT.26/23). Asia Pacific Network Information Centre (APNIC) Foundation under the Switch! Projec